{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T23:52:55Z","timestamp":1765497175104,"version":"3.48.0"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"12","funder":[{"DOI":"10.13039\/501100004761","name":"Natural Science Foundation of Hunan\n                        Province","doi-asserted-by":"crossref","award":["2023JJ40499"],"award-info":[{"award-number":["2023JJ40499"]}],"id":[{"id":"10.13039\/501100004761","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Scientific Research Fund Project of Hunan University of Chinese\n                        Medicine","award":["2022XYLH004"],"award-info":[{"award-number":["2022XYLH004"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To investigate the clinical features of nivolumab-induced isolated\n                    adrenocorticotropin deficiency and to provide a reference for the diagnosis,\n                    treatment and rational use of nivolumab, clinical reports of nivolumab induced\n                    isolated adrenocorticotropin deficiency were collected by searching the database\n                    until August 31, 2025. Clinical data were collected and retrospectively\n                    analyzed. Seventy-one patients were enrolled, with a median age of 66 years\n                    (range: 26\u201387), and 73.2% of whom were male and 67.6% from Japan. Melanoma\n                    (36.6%) was the main indication for nivolumab. The median time from initiation\n                    of nivolumab to the onset of isolated adrenocorticotropin deficiency was 24\n                    weeks (range: 3\u201360) and the median was 8 cycles (range: 2\u201333). Fatigue (76.1%),\n                    anorexia (66.2%) and nausea (23.9%) were the most common symptoms of isolated\n                    adrenocorticotropin deficiency. Laboratory tests revealed hyponatremia (50.7%)\n                    and eosinophilia (28.2%). Pituitary magnetic resonance imaging showed no\n                    abnormality in most patients (71.8%). Thyroid dysfunction (26.8%) often coexists\n                    with isolated adrenocorticotropin deficiency. These patients had a good\n                    prognosis after receiving a physiological dose of hydrocortisone.\n                    Nivolumab-induced isolated adrenocorticotropin deficiency is a rare disorder\n                    with possible racial differences. The possibility of isolated\n                    adrenocorticotropin deficiency should be considered in patients with fatigue and\n                    fatigue during treatment. Serum sodium and eosinophil ratios should also be\n                    closely monitored. The prognosis is good after hydrocortisone replacement\n                    therapy.<\/jats:p>","DOI":"10.1055\/a-2731-0683","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:04:22Z","timestamp":1764029062000},"page":"673-678","source":"Crossref","is-referenced-by-count":0,"title":["Retrospective Analysis of Nivolumab-Induced Isolated\n                    Adrenocorticotropin Deficiency"],"prefix":"10.1055","volume":"57","author":[{"given":"Wei","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The First Hospital of Hunan\n                    University of Chinese Medicine, Changsha, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"He","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The First Hospital of Hunan\n                    University of Chinese Medicine, Changsha, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2548-3980","authenticated-orcid":false,"given":"Zhiqiang","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The First Hospital of Hunan\n                    University of Chinese Medicine, Changsha, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"127","DOI":"10.4103\/apjon.apjon_4_17","article-title":"Immune Checkpoint inhibitors: an innovation in immunotherapy for the treatment\n                    and management of patients with cancer","volume":"4","author":"J Dine","year":"2017","journal-title":"Asia Pac J Oncol Nurs"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s40425-018-0316-z","article-title":"Development of PD-1 and PD-L1 inhibitors as a form of cancer immunotherapy: a\n                    comprehensive review of registration trials and future considerations","volume":"6","author":"J Gong","year":"2018","journal-title":"J Immunother Cancer"},{"issue":"17","key":"ref3","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1200\/JCO.2017.77.6385","article-title":"Management of immune-related adverse events in patients treated with immune\n                    checkpoint inhibitor therapy: american society of clinical oncology clinical\n                    practice guideline","volume":"36","author":"J R Brahmer","year":"2018","journal-title":"J Clin Oncol"},{"issue":"12","key":"ref4","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1210\/jcem-14-12-1519","article-title":"True pituitary addison's disease, a pituitary unitropic deficiency;\n                    fifteen-year follow-up","volume":"14","author":"A STEINBERG","year":"1954","journal-title":"J Clin Endocrinol Metab"},{"issue":"08","key":"ref5","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.autrev.2008.04.016","article-title":"Pituitary autoimmunity: 30 years later","volume":"7","author":"P Caturegli","year":"2008","journal-title":"Autoimmun Rev"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1001\/jamaoncol.2017.3064","article-title":"Incidence of endocrine dysfunction following the use of different immune\n                    checkpoint inhibitor regimens: a systematic review and meta-analysis","volume":"4","author":"R Barroso-Sousa","year":"2018","journal-title":"JAMA Oncol"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"102454","DOI":"10.1016\/j.autrev.2019.102454","article-title":"Isolated autoimmune adrenocorticotropic hormone deficiency: From a rare disease\n                    to the dominant cause of adrenal insufficiency related to check point\n                    inhibitors","volume":"19","author":"R Percik","year":"2020","journal-title":"Autoimmun Rev"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1007\/s11102-021-01141-8","article-title":"Isolated ACTH deficiency induced by cancer immunotherapy: a systematic\n                    review","volume":"24","author":"P Iglesias","year":"2021","journal-title":"Pituitary"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1056\/NEJMoa1504030","article-title":"Combined nivolumab and ipilimumab or monotherapy in untreated melanoma","volume":"373","author":"J Larkin","year":"2015","journal-title":"N Engl J Med"},{"issue":"10","key":"ref10","first-page":"391","article-title":"A case of nivolumab-induced isolated adrenocorticotropic hormone deficiency\n                    presenting dyspnea","volume":"64","author":"K Ito","year":"2018","journal-title":"Hinyokika Kiyo"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1111\/cen.14082","article-title":"Comparative analysis of human leucocyte antigen between idiopathic and anti-PD-1\n                    antibody induced isolated adrenocorticotropic hormone deficiency: A pilot\n                    study","volume":"91","author":"H Inaba","year":"2019","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.ejca.2020.02.049","article-title":"Human leucocyte antigen DR15, a possible predictive marker for immune checkpoint\n                    inhibitor-induced secondary adrenal insufficiency","volume":"130","author":"S Yano","year":"2020","journal-title":"Eur J Cancer"},{"issue":"19","key":"ref13","doi-asserted-by":"crossref","first-page":"3167","DOI":"10.1200\/JCO.2009.26.7609","article-title":"Phase I study of single-agent anti-programmed death-1 (MDX-1106) in refractory\n                    solid tumors: safety, clinical activity, pharmacodynamics, and immunologic\n                    correlates","volume":"28","author":"J R Brahmer","year":"2010","journal-title":"J Clin Oncol"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s11102-006-0408-5","article-title":"Isolated corticotrophin deficiency","volume":"9","author":"M Andrioli","year":"2006","journal-title":"Pituitary"},{"key":"ref15","first-page":"19-0102","article-title":"Clinical heterogeneity of hypophysitis secondary to PD-1\/PD-L1 blockade:\n                    insights from four cases","volume":"2019","author":"I Lupi","year":"2019","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1080\/17446651.2019.1701434","article-title":"Hypophysitis induced by immune checkpoint inhibitors: a 10-year assessment","volume":"14","author":"G Di Dalmazi","year":"2019","journal-title":"Expert Rev Endocrinol Metab"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1093\/jjco\/hyy201","article-title":"Correlation between blood cell count and outcome of melanoma patients treated\n                    with anti-PD-1 antibodies","volume":"49","author":"Y Nakamura","year":"2019","journal-title":"Jpn J Clin Oncol"},{"issue":"4741","key":"ref18","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1136\/bmj.2.4741.1183.","article-title":"The eosinopenic response to cortisone and ACTH in normal subjects","volume":"2","author":"J H Kellgren","year":"1951","journal-title":"Br Med J"},{"issue":"11","key":"ref19","doi-asserted-by":"crossref","first-page":"4078","DOI":"10.1210\/jc.2014-2306","article-title":"Ipilimumab-induced hypophysitis: a detailed longitudinal analysis in a large\n                    cohort of patients with metastatic melanoma","volume":"99","author":"A T Faje","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s12902-015-0082-6","article-title":"Neurological symptoms in a patient with isolated adrenocorticotropin deficiency:\n                    case report and literature review","volume":"16","author":"Y Goto","year":"2016","journal-title":"BMC Endocr Disord"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"578802","DOI":"10.3389\/fendo.2021.578802","article-title":"Clinical heterogeneity of acquired idiopathic isolated adrenocorticotropic\n                    hormone deficiency","volume":"12","author":"Y Fujita","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1158\/1078-0432.CCR-14-2353","article-title":"Systemic high-dose corticosteroid treatment does not improve the outcome of\n                    ipilimumab-related hypophysitis: a retrospective cohort study","volume":"21","author":"L Min","year":"2015","journal-title":"Clin Cancer Res"},{"issue":"07","key":"ref23","first-page":"662","article-title":"Management of side effects of immune checkpoint blockade by anti-CTLA-4 and\n                    anti-PD-1 antibodies in metastatic melanoma","volume":"14","author":"K C K\u00e4hler","year":"2016","journal-title":"J Dtsch Dermatol Ges"}],"container-title":["Hormone and Metabolic Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2731-0683.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T23:50:49Z","timestamp":1765497049000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2731-0683"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,24]]},"references-count":23,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,11]]},"published-print":{"date-parts":[[2025,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2731-0683","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0018-5043","1439-4286"],"issn-type":[{"type":"print","value":"0018-5043"},{"type":"electronic","value":"1439-4286"}],"subject":[],"published":{"date-parts":[[2025,11,24]]}}}